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Testing Report for 2020-05-31-8-10

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

DEA: 080K1214
EFIS: 0815000245
Project ID: 213970
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-12.5/14.8
Work Description: REPLACE PCC PAVEMENT WITH JPCP AND PRECAST JOINTED CONCRETE PAVEMENT.
Location Description: SAN BERNARDINO COUNTY IN FONTANA AND NEAR DEVORE FROM 0.3 MILE SOUTH OF SIERRA AVENUE UNDERCROSSING TO GLEN HELEN PARKWAY UNDERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Vu Thanh Nguyen
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2020-05-31-8
TL Number from the TL Form:
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Annual Source Testing
Type of Material: Aggregate
Sample Taken Date: 5/31/2020
Date that the sample was received by the laboratory/organization performing the testing: 6/2/2020
The quantity of what the sample constitutes: 8 Bags
A brief description of the sample: 1.0" X No.4 Pcc Aggregate
From where was the sample collected: Source
Laboratory sample identification: 1151
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Robertsons-Rialto

Material Information

Source Identification (SMARA or name of Pit): 91-36-0146
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Robertson Rialto
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number: Unknown
Lot number: Unknown
Sublot number: Unknown

Test Information

DIME Test ID: 2020-05-31-8-10
Test Method: CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)
Date Tested: 6/10/2020
Verified Date: 6/29/2020
Submitted By Organization: CT - Southern Regional Laboratory
Organization Address: 13970 Victoria St,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 213-792-4794
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Cleanness value (single primary size): 81